Provider Demographics
NPI:1538295530
Name:ZHARNITSKY, MARK SR
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:ZHARNITSKY
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 82ND ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1305
Mailing Address - Country:US
Mailing Address - Phone:718-426-3333
Mailing Address - Fax:718-426-6387
Practice Address - Street 1:4010 82ND ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1305
Practice Address - Country:US
Practice Address - Phone:718-426-3333
Practice Address - Fax:718-426-6387
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041032122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist